Hospice Benefit

The Hospice Benefit covers 100% of Reasonable and Customary charges for the services outlined in the following chart up to a lifetime maximum shown in the Schedule of Benefits .

To be eligible for hospice benefits, the hospice care must be rendered as part of a Hospice Care Program by a licensed Hospice Care Agency. Before a covered individual enrolls in a Hospice Care Program, they should contact the Fund Office to verify that services will be covered under this benefit.

Schedule of Benefits for Hospice Services 

Home Hospice Care - Allows patient to receive care in his or her own home.

Services and equipment covered at 100% include: Physician services, Physical, respiratory and occupational therapies, Drugs, medications and medical supplies when provided under the Hospice Care Program through Hospice Care Agency, Private duty nursing services by a Registered Nurse or Licensed Practical Nurse, if certified by a Physician, Rental of Durable Medical Equipment (DME), as described in Appendix A , and Oxygen and rental of related equipment.

Outpatient Hospice Care – Care that you receive in a licensed medical facility. After you receive treatment, you return to your home.

Services covered at 100% include: Physician services, Laboratory, x-ray and diagnostic testing, and Ambulance service or alternative types of transportation.

Inpatient Hospice Care – Care received while you are an admitted patient in a Hospital or Hospice facility.

Services covered at 100% include: Room and board which may include overnight visits by family, Nursing services, All other related Hospital expenses, Physician services, and Ambulance service or alternative types of transportation.

Other Services – In addition to the services outlined above, certain other services for you and your family are also covered.

Services covered at 100% include: Visits by a licensed social worker to evaluate the social, psychological and family problems related to the terminal illness. In addition, this professional will help develop a plan to assist in resolving these problems; Emotional support services to help relieve stress, cope with the anticipated loss, complete unfinished family business and maintain the patient in the most appropriate environment; Special incidental services for the patient, such as special dietary requirements, transportation between home and other sites of care; and Bereavement counseling for the immediate family following the death of the Hospice patient. (Coverage is limited to six visits at a maximum expense of $50 per visit.)